Individual
JACK C. GLADMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
3635 S SONCY, AMARILLO, TX 79119
(806) 356-6868
(806) 351-0120
Mailing address
3635 S SONCY, AMARILLO, TX 79119
(806) 356-6868
(806) 351-0120
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
03941TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
81968Q
BCBS
TX
Enumeration date
05/15/2006
Last updated
10/24/2007
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